2419    Protein Detection in the Clinical Laboratory
8:00am - 3:30pm    6.5 CMLE Credits

Darci R. Block, Ph.D., DABCC
Co-Director, Central Clinical Laboratory and Central Processing, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN

Dina N. Greene, PhD, DABCC, CCS, C(ASCP)
Clinical R&D Scientist, Regional Laboratories, Northern California, The Permanente Medical Group, Berkeley, CA

Proteins are a fundamental component of human physiology, and oftentimes pathology.  Accurately detecting proteins is integral for patient care, as their quantitative or qualitative identification is used for both diagnosis and monitoring. This workshop will use an integrative approach to underline each of the major methodologies utilized to accurately detect proteins in the clinical laboratory. You'll participate in discussions regarding:
  • the fundamental properties of proteins, their role in human physiology, their importance in pathology, and the current and future methods of detection  
  • enzymes and the utility that quantifying their activity in blood has on patient management in a wide variety of diseases
  • the detection of variant plasma proteins by electrophoresis, illustrated by two disorders that rely heavily on the clinical laboratory – hemoglobinopathies and multiple myeloma 
  • the use of immunoassays for detecting and quantifying proteins, identifying and investigating interferences, and the need for immunoassay harmonization.  Particular emphasis will be placed on human chorionic gonadotropin (hCG), as it is a model protein to emphasize the inherent biological variability of proteins, and how this variability has a direct effect on laboratory immunoassays.  
  • practical advice on performing body fluid testing as well as a review of its clinical utility  

Throughout this workshop case studies will punctuate the importance of the concepts covered and interactive questions (using audience response) will aid in self assessment. You will gain a balanced understanding of the biochemistry, pathology, and techniques that are integral to understanding the role of proteins in the clinical laboratory.

Following this workshop, you will be able to:

  • Describe how enzymes and proteins are produced and when and how their measurement can be used clinically. 
  • Analyze serum protein electrophoresis and describe its use in screening for hemoglobinopathies and
  • Monoclonal gammopathies. 
  • Describe the analytical utility and drawbacks of quantifying proteins by immunoassay  
  • Write and perform an analytical validation for body fluid matrices and describe the clinical utility for performing the tests.  

4772  It’s Not Just SOPs Anymore!  (Half Day) 
8:00am – 11:30pm   3.5 CMLE Credits

President, Laboratories Made Better! P.C., Broomfield, CO

What is the use of a procedure manual if no one but the inspector looks at it? Documents should be written to provide direction and instruction to both management and technical staff--not just to make the inspectors happy. Yet most laboratory SOPs fail to communicate vital information in a way that ensures comprehension and a successful outcome. Attend this workshop for a fresh approach to meeting regulatory and accreditation requirements for documents while creating succinct, understandable SOPs based on the way work actually happens in the laboratory. In this workshop, you will learn how to:
   • implement an effective document management process – whether in a paper or electronic environment
   • identify four types of laboratory documents and their respective uses
  • make laboratory documents brief, complete, and consistent
  • draft selected types of documents.

You will leave this workshop with an understanding of the power of effective documents, a plan for transitioning your laboratory’s current documents to better formats, and a list of resources for further help on this subject. [Note: This workshop is a useful, but not required, prelude to the “Flowchart Away Laboratory Problems” workshop.] 

Following this workshop, you will be able to:
• Implement an effective document management process.
• Describe the four types of documents and their uses in the laboratory.
• Distinguish among process, procedure, and SOP.
• Apply established templates when writing laboratory documents.

Debut Presentation! 
4773   Flowchart Away Laboratory Problems!  (Half Day) 
12:30 pm - 4:00pm     3.5 CMLE Credits

President, Laboratories Made Better! P.C., Broomfield, CO

All work is a series of processes¾and laboratories of all sizes, scopes, and specialties have preanalytic, analytic and postanalytic processes. Yet there is wide variation in staff understanding of the same process within the same laboratory, especially when the process involves persons outside the laboratory walls, such as patients and other health care professionals. Flowcharting a process has historically been reserved for doing root cause analyses of sentinel events. However, it is a most valuable¾and proactive¾tool for identifying existing bottlenecks, redundancies, and document problems in your laboratory’s processes that staff deals with time after time, day after day. Learn how to properly construct laboratory process flowcharts and use these flowcharts to do all of the following:

  • visualize how work happens in your laboratory

  • enhance communication inside and outside the laboratory

  • identify needed procedures, forms, and job aids

  • simplify staff training and competence assessment

  • improve performance on regulatory and accreditation assessments

This is an active workshop with group discussion and development of selected laboratory flowcharts. You’ll leave with a new skill and a list of additional resources for flowcharting your laboratory’s processes.

Following this workshop, you will be able to:

  • Discuss four benefits of documenting an entire process on one page.

  • Identify at least 6 laboratory processes that should be flowcharted.

  • Discover existing bottlenecks, redundancies, and document problems in your laboratory’s processes.

  • Utilize flow charts to improve training and competence assessment.

5783  Peripheral Smears: The Primary Diagnostic Tool Part II: Hemolytic Anemias, Neoplasms, and More

8:00am - 4:30pm  7.5 CMLE Credits

Irma Pereira, MT(ASCP)SH
Emerita,, Clinical Hematology Specialist and Consultant, Clinical Hematology; Adjunct Lecturer in Hematology, Department of Medicine, Stanford University Hospital, Stanford, CA

Although this workshop is a continuation of Part I (presented on June 11), the workshops may be taken individually.

This intermediate workshop uses more than four hundred images to demonstrate techniques for the peripheral smear diagnosis of hematologic disorders. Geared to improving your diagnostic ability, so crucial to proper evaluating a patient's hematological status, this session will increase your confidence and productivity in the hematology laboratory. You will:

  • learn techniques for peripheral smear differential diagnosis of microcytic anemias, macrocytic anemias and the extracorpuscular and intracorpuscular hemolytic anemias
  • hear detailed presentations on:  
    • the WHO classification of lymphoid leukemia/ lymphoma and its rare leukemic variants,  including detailed explanations of the morphological differentiation of B-cell and T-cell leukemia/lymphoma disorders
    • peripheralized mature B-cell neoplasms, such as: CLL, SLL/PLL, mantle cell (splenic and nodal), Marginal, Burkitt, myeloma   (secretory and non- secretory), Waldenstrom, hairy cell, follicular 
    • aggressive transformation of CLL (Richer Syndrome)
    • Sezary Syndrome
    • reactive lymphocytosis vs. lymphoma
    • disorders, such as the Chediak-Higashi Syndrome and certain mucopolysaccharide disorders
    • intracellular organisms

Following this workshop, you will be able to:
  • More accurately diagnose hematologic problems through improved morphologic skills.
  • Guide non-hematologist physicians to a clearer understanding of patient disorders.
  • Alert physicians to unknown hematologic situations.
  • Discuss patient diagnoses at a higher technical level.